- Recent posts
- Neurolinguistic programming: "Wouldn't it be nice if patients always did what they were told?"
- A night to remember
- Congratulations to the Institute of Osteopathy, Norway
- Osteopathy for All: 1st Place Children's Centre
- New clinic booking system goes live
- Countdown to the Olympics: Part 1
- Inside our Community Clinics: The Manna Centre
- Living in London: Advice from a lifelong resident
- Life outside the lecture theatre
- Chapman Clinic awarded £20,000 by the Peter Moores Foundation
- Archive
- November 2011
- Categories
- Results
- Recent news and events
- Archive
Risky practice
Posted By Stephen Tyreman | Tags: CPD, professional practice, risk, personal development | Comments (1)
Getting up in the morning is risky, driving to work is risky, indeed life is risky; so what is special about clinical practice in terms of risk? A risk represents a hazard or danger and clearly we wish to avoid dangerous situations. But we also know that human development is marked by people who took risks. From explorers to business entrepreneurs, from philosophers (it’s surprising how many were killed for their ideas) to researchers (Marie Curie died from radiation poisoning and Edward Jenner vaccinated his own children with cowpox to demonstrate his faith in his inoculation), a common feature is that they took risks and faced hazards in order to gain benefit and reward.
In a world that is increasingly risk averse how should we understand and react to the range of risks that confront us in practice? Is the ideal to remove all risk? What is an acceptable level of risk? On a harm-benefit balance, how much potential harm are we willing to tolerate in order to gain benefit; or put the other way, how much benefit do we need to gain to take a certain level of risk?
Health care practice has always lived with these kinds of risks but an increasingly litigious society now means that it is not enough for practitioners to decide what an acceptable level of risk is. Patients are expected to be informed and involved in decisions about what is an acceptable level of risk. The thing is, human beings are not naturally equipped to evaluate risk; we don’t understand probability because big numbers are not intuitive. The Birthday Paradox, for example, asks how many people need to be together in a room for it to be likely (the opposite of risk) that two of them have the same birthday. There are 365 possible days (ignoring leap years) on which someone could be born, so we might expect to need quite a large number. In fact, with only 23 people there is a 50% chance and with 40 people there is a 90% chance of two of them sharing a birthday.
The Risky Practice conference will take place on Saturday 3 March and will explore a number of issues around understanding and managing risk in practice. For more information, visit our CPD section.
Comments (1)
Neil Mellerick:
Feb 06, 2012 at 07:29 PM
We can attempt to evaluate risk on a number of levels as practitioners. Anecdotal evidence and more recent research suggests that risk of serious harm is low, hence the need to wield the 'large numbers'
As experts it is our duty to communicate our understanding of the various risks to our clients in a manner they can understand. Also as experts we are expected not to follow processes that we understand to have high risk. We are not surgeons, we do not use anaesthetics or powerful pharmaceutical drugs so most (but not all!) of our risks fall into a much lower category of potential harm.
For our clients/patients it is not just the risk of adverse reactions. For many especially in the current climate there is the financial risk of a poor response to treatment- the risk of a lack of 'value for money' and once again in the absence of hard evidence we have to become more communicative in respect of prognosis.
Unfortunately I can't attend this years conference but I look forward to some good debate!